"Medicine is a social science, and politics is nothing else but medicine on a large scale"—Rudolf Virchow

May 11, 2014

Another look at today's Saudi MERS report

This morning I posted the KSA MOH's May 11 report, MOH: '3 New Confirmed Corona Cases Recorded'. I was away from my computer for several hours, and on returning I see a number of tweets pointing out that the Saudis are really reporting four cases—three in "stable" condition, whatever that means, and "1 case that has not displayed any symptoms." I was formatting the post too quickly to notice the discrepancy.

Now that it's been raised, this discrepancy worries me, because we don't learn anything else about this case. Male or female? Location? Presumably tested for MERS due to a contact of some kind with a confirmed case, but when?

Given how little we still know about this virus and its effects on humans, it seems to me a little reckless to shrug off asymptomatic cases and fail even to count them. Failing to explain why only makes matters worse. After all, WHO still defines asymptomatics as cases.

This is a sudden change. The MOH May 8 report lists two such asymptomatics as cases and gives us the details: a 34-year-old man in Riyadh and a 22-year-old man in Jeddah, both of them contacts of confirmed cases. The May 9 report lists 5 such cases, and the May 10 report lists 2.

So by May 10 rules, we should have tallied 484 cases on May 11. By May 11 rules, we've got 473—or maybe scores fewer going back to September 2012. Let this go on for any length of time, and we'll have two seriously divergent case counts.

A positive MERS test should be the only grounds for defining a case, whether some cases are asymptomatic and some are suffering multiple organ failure.

Comments

Another look at today's Saudi MERS report

This morning I posted the KSA MOH's May 11 report, MOH: '3 New Confirmed Corona Cases Recorded'. I was away from my computer for several hours, and on returning I see a number of tweets pointing out that the Saudis are really reporting four cases—three in "stable" condition, whatever that means, and "1 case that has not displayed any symptoms." I was formatting the post too quickly to notice the discrepancy.

Now that it's been raised, this discrepancy worries me, because we don't learn anything else about this case. Male or female? Location? Presumably tested for MERS due to a contact of some kind with a confirmed case, but when?

Given how little we still know about this virus and its effects on humans, it seems to me a little reckless to shrug off asymptomatic cases and fail even to count them. Failing to explain why only makes matters worse. After all, WHO still defines asymptomatics as cases.

This is a sudden change. The MOH May 8 report lists two such asymptomatics as cases and gives us the details: a 34-year-old man in Riyadh and a 22-year-old man in Jeddah, both of them contacts of confirmed cases. The May 9 report lists 5 such cases, and the May 10 report lists 2.

So by May 10 rules, we should have tallied 484 cases on May 11. By May 11 rules, we've got 473—or maybe scores fewer going back to September 2012. Let this go on for any length of time, and we'll have two seriously divergent case counts.

A positive MERS test should be the only grounds for defining a case, whether some cases are asymptomatic and some are suffering multiple organ failure.